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Emerging Technologies for Assisted Fracture Reduction: A Systematic Review
J Forssling1, P Andreasen1, T R Savarimuthu1
1Maersk Mc-Kinney Moller Institute, SDU Robotics, University of Southern Denmark, Campusvej 55, DK-5230, Odense, Denmark.
Background:
Bone fractures pose a major healthcare challenge, affecting millions of people worldwide. Achieving excellent fracture reduction is critical for successful outcomes yet remains difficult with current surgical tools. Poor reduction quality contributes significantly to implant failure and reoperation rates. Consequently, various technology-assisted solutions such as 3D printing, robotics, and computer-assisted systems have been proposed to support surgeons in achieving optimal reduction. This article presents a systematic review of these emerging technologies designed to support fracture reduction.
Methods:
A systematic search of PubMed, Web of Science, and Scopus was conducted on October 31, 2025, covering studies published between January 2016 and October 2025. Inclusion criteria focused on new technologies applied pre- or intraoperatively to assist fracture reduction. After screening and applying exclusion criteria, 62 studies were included and categorized into three domains: 3D printing (including anatomical models, surgical guides/tools, and implants), Robot-Assisted Fracture Reduction (RAFR), and computer-assisted technologies. Reported outcomes included operative time, blood loss, radiation exposure, reduction quality, and functional recovery.
Results:
3D printing was the most frequently studied, primarily through anatomical models, mirror models, and patient-specific surgical guides. Across studies, 3D printing consistently reduced operative time (16-50%) and blood loss (15-75%) compared with conventional methods, though limited by long production times and regulatory constraints. RAFR systems, particularly navigation-focused platforms, demonstrated reduced radiation exposure (20-60%) and improved surgical precision. Computer-assisted approaches are emerging but with limited clinical validation to date.
Conclusions:
Technology-assisted solutions can provide measurable benefits in the reduction of fractures. Among the reviewed technologies, navigation-based RAFR systems and 3D-printed surgical guides appear to have relatively stronger clinical support, though evidence remains limited. However, significant barriers remain, including workflow integration, cost, and regulatory approval. Future research should focus on accelerating translation from prototype to practice, with emphasis on clinical validation and real-time usability.
